How to Get Rid of Acne Scars?

Could someone tell me the best way to get rid of acne scars on my chin and my cheeks?

Doctor Answers 30

Rid of acne scarring

Acne scars can be a very troubling problem. Even though the acne breakouts may be controlled or have long since stopped, the scarring remains for a lifetime.

Treatment for acne can be as troublesome as the disease itself. Usually, successful treatment requires a team approach with a dermatologist and a cosmetic surgeon.

First, attention must be turned to stopping any outbreaks, then repair of the scarring. If outbreaks continue, scarring is likely to continue, and any treatments aimed at treating scarring would be futile. There are many options for treatment of acne today depending on the severity of outbreaks. These are beyond the scope of this article, except to say that treatment for the underlying disease process is a must. Once the outbreaks are well controlled, attention can be turned toward erasing the lasting marks on the face.

Of note, acne is not only a disease of adolescence. Adult onset acne is not completely uncommon and is seen in women who are pregnant – often with more severe scarring. Treatment options for acne scars depend on the severity of the scarring and the skin type of the person wishing repair.

In people with darker skin, Fitzpatrick Types V, VI; options are limited because of concern for pigment irregularities after treatment. For lighter skinned individuals, treatments range from simple facial exfoliation to deep chemical or laser peels to surgical intervention.

For light scarring after acne, attention is placed on skin resurfacing. By taking off the outer layers of skin and stimulating collagen synthesis with new skin formation, acne scars can be reduced. This is best simulated by placing a finger on either side of an area of scarring and lightly pulling. If the scars fade, this can be a good option for resurfacing.

For deeper scars, a deep chemical peel, ablative laser (CO2 or erbium) resurfacing, or dermabrasion/dermasanding may be necessary. For deeper scars, deeper solutions are necessary. Again, several options exist.

  • Deeper scars can be surgically excised with the larger acne scar replaced with a surgically placed small line. This can later be refined with other rejuvenation techniques.
  • Punch grafting affords a simple method for treating multiple scars. A circular punch is used to create an incision around an acne scar. The scar is then allowed to heal and the resulting skin irregularity is smoothed.
  • Subcision involves releasing the tethering attachments underneath the scar and then filling the space with either a temporary or permanent filler to prevent the scar from reforming when it heals. With the advent of new temporary artificial fillers such as hyaluronic acid, this is a good option for larger depressed scars.

Whatever the treatment option, it is important to consult a physician with a large arsenal of treatment options – if a physician only sells a cheeseburger, then you get sold a cheeseburger, even if you need a bacon burger. It is also important to remember that just as acne scars did not form overnight, treatment can sometimes take months to get the desired result. Once you find an experienced physician and decide on a treatment option, remember that it’s a long road but one that is usually worth the wait.


Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

How to get rid of acne scars

Acne scars can cause red or brown discoloration and uneven skin contour. Usually multiple types of treatments are needed for maximum improvement. Patience is key since the full effect is often not seen for several months. 

Skin discoloration and texture can be improved with topical treatments like hydroquinone and Retin-A, but for deeper scars and more significant discoloration, other techniques are needed.

Small, deep acne scars can be treated with surgical excision, which will ideally trade a depressed and discolored scar for a thin, flat scar.This is often followed by other resurfacing techniques like laser, chemical peel or dermabrasion to further smooth the skin and minimize scarring.

Other techniques to improve large or numerous scars involve resurfacing the skin by intentionally traumatizing it in order to stimulate collagen production. This thickens the skin and shrinks the surface area of the scar, and color may be improved as well. The Cross technique uses a very concentrated TCA peel. There are multiple types of laser as well, and the best choice depends on the degree of improvement needed as well as your skin color. Unfortunately options are limited for patients with dark skin due to an increased risk of skin discoloration.

Risks for all these techniques include temporary or permanent lightening or darkening of treated skin, crusting, scabbing, persistent or new scarring, reactivation of cold sores, infection, redness, acne flares, and milia formation.

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 23 reviews

Acne scar treatment in Los Angeles

Our office specializes in acne scar treatments for all skin types, including Asian and African American skin. We use a combination of ablative, non ablative, sublative, and resurfacing treatments to improve acne scars. 

Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 63 reviews

Getting rid of acne scars

There are generally three viable alternatives that we utilize on a regular basis:

  1. Erbium Laser which generally works with one treatment, but can be repeated if desired.
  2. Fraxel Laser which generally provides some improvement after 5 or 6 treatments.
  3. Injectables to fill the acne scars. This provides temporary but quick improvement of acne scars.

With any of these alternatives, you should find an experienced practitioner who is well trained.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 25 reviews

Improving acne scars

While there is no way to make one’s skin that of a porcelain doll, acne scars can be improved. This usually requires a number of treatments with the CoolTouch, Smooth Beam, Affirm, Active FX or Fraxel lasers, which can minimize their appearance.

We often combine lasers with subcision and/or injection of fillers.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.5 out of 5 stars 7 reviews

Acne Scar Treatments

I’m sorry to hear that you are struggling with acne scarring, but good news: there are many options to treat those scars. The method that is best suited for you will depend on the depth of the scars, among other variables. For lighter or minimally scarring, I suggest:
  • Microdermabrasion can be likened to a "superficial skin polishing" using micro crystals vacuumed through a delicate hand piece. In as little as 20 minutes, this gentle abrasive technique efficiently produces satisfying results. Treatments are progressive and are applied through a course of weekly sessions. Often not sufficient for most acne scars as it does not go deep enough. Dermabrasion, which abrades the top layer of skin down to the dermis, is more effective for atrophic scarring.
  • Microneedling uses acupuncture-like needles to pierce the skin. These “micro-injuries” cause the controlled start of the skin’s self-repair mechanism, which triggers new collagen production without the risk of permanent scarring. The result is typically smoother, firmer looking skin. Skin needling procedures are performed in a safe and precise manner with the use of a sterile Micropen needle head.
  • Chemical peels cause the skin to exfoliate and produce fresh new skin cells. There are different peels of varying strengths based on the results that you want. Usually 3-5 peels will be needed. Often not sufficient for most scarring as these typically do not work deep enough. A stronger chemical peel, 100% TCA used in a “cross hatch” technique, is an effective treatment for “ice pick” scarring.
If you scarring is deeper or more extreme these procedures may work best for you:
  • Dermal filler injections are good for shallow and deep scars. These fillers can be injected into the area of the scar, smoothing depressions. Results are immediately apparent. Bellafill, a long lasting filler, is now FDA approved for these treatments. Also high grade silicone can be an effective treatment when used properly.
  • Subcision is a technique that breaks apart the scar tissue under depressed scars with a special needle. New tissue is created that raises the scar or unwanted depression.
  • Non-Ablative laser treatments are not painful and there is no downtime. Most patients receive a series of about 5 treatments. Benefit from this type of laser is usually subtle. (i.e. the improvement is gradual).
  • Fractional skin resurfacing treats facial scars by delivering the laser's energy in microbeams and is an effective treatment for many types of acne. Fractional treatments promote the production of softer, smoother skin.
  • Laser resurfacing (fully ablative laser) is less commonly utilized these days. It is typically considered an aggressive treatment for acne scarring. It can, produce dramatic improvements, but comes with significantly longer downtime and a greater risk of post laser scarring and or redness.

David J. Myers, MD
Salt Lake City Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Treating Acne Scars

There are many options for treatment of acne scars because there are different types of acne scars depending on the depth and severity of scarring. I strongly suggest you get a consultation to determine the best modality or modalities to reduce appearance of your scarring. Lasers, chemical peels, micro pen, radio frequency and ultrasound can all be successfully used in treatment.

Melda A. Isaac, MD
Washington DC Dermatologic Surgeon
5.0 out of 5 stars 1 review

Acne Scarring

First you need to consider if you are still having outbreaks.  If you are, that is the first thing we would want to control, so that you are not creating new scars that will later need to be treated.  If you are not, you can proceed to treat your current scarring.  As with anything,  the treatment plan is dependent on factors such as skin type and severity of the scarring itself.  There are treatments that work well to help for the color of the scar and treatment for the texture or depression of the scar.  Broad Band Light is an option for the red/purple scarring.  Laser Resurfacing/Peels with help with the texture.  New the market for acne scarring is BellaFill, which is a lasting filler where you actually go in and fill the individual scars. The best treatment will be based around your individual needs.

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.5 out of 5 stars 29 reviews

It depends on what type of acne scars they are...

acne scarring is highly dependent on factors such as the TYPE of acne scar, your skin type and the location of acne scars. This is the basis behind scar removal. 
Laser can help- the remodel collagen.
Subscion and surgery and break scars down or cut scars out
Fillers can treat divets, and atrophic scars
TCA CROSS can help with deep acne scars- called Ice Pick scars
RF or RF Needling can help stimulate and remodel collagen

The majority of patients will have several scar types, and hence multiple treatments are needed for optimal outcomes. 

Regards

Dr Davin S. Lim
Laser and aesthetic dermatologist
Brisbane and Gold Coast
Australia

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 13 reviews

Acne Scar Treatment

This is a tough question and a tough problem.  There is no one right answer but the good news is that today there are some good alternatives that should be considered.  

The first step is to smooth out the canvas so to speak.  The holes, pits and undulations that acne scarring can make are impossible to cover.  Some solutions include:
  • Excision on the scars works for the really deep and extensive scars. In this case the deep, wide scars are traded for surgical scars that are hopefully thin and flat but it depends a little on how you heal and location of the scar.
  • Filling the scar with a filler and using subcision to get a flat surface. Subcision is a technique that helps to release the scar from below to help flatten it out. Filler is used as well. The long term fillers like Artefill are exceptional for this and in fact Artefill is in the process of getting FDA approval for this specific application.
  • '"Sanding" the raised areas. This used to be accomplished with dermabrasion but today better results can be achieved with an ablative laser treatment.
The second step is to even out the skin tone and color. Again there are various alternatives for this. Ablative lasers work well as does Broad Band Light Therapy or BBL. Deep chemical peels like a Croton oil peel are also a good choice. These treatments are aggressive but exceptional results are possible in the right hands and with the right patient.


I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.